| Occmed Source, Llc | |
|
174 Currie Hall Pkwy Suite D Kent OH 44240-4387 | |
| (330) 548-0086 | |
| (330) 548-0085 |
| Full Name | Occmed Source, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 174 Currie Hall Pkwy, Kent, Ohio |
| Authorized Official Name and Position | Gregory A Moten (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3305480086 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Occmed Source, Llc 174 Currie Hall Pkwy Suite D Kent OH 44240-4387 Ph: (330) 548-0086 | Occmed Source, Llc 174 Currie Hall Pkwy Suite D Kent OH 44240-4387 Ph: (330) 548-0086 |
| NPI Number | 1003076431 |
|---|---|
| Provider Enumeration Date | 06/10/2008 |
| Last Update Date | 06/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003076431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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